Homestead_Ziliak (16) H. PREPARER
Preparer of the Sales Disclosure Form Title
Thomas P.Norton Attorney at Law
Company E-mail address
Address(number and street,city,state,country,and ZIP Code)
2230 W.Franklin St, Evansville, IN 47712
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Marlene A. Fetter, 514ccc&so, irul-k( °� ~d'1 F PGA('-r� Debra S.Rietman, S1, crssor ,—iuJ{cf of F_dI,+ 4 ggcti l
ZYv�.76-41f �rc+s '�t✓oc- (f Tiw.ff-
Address(number and street) Address(number and street)
701 W.church St 242 S. Eickhoff Rd
City,state,and ZIP Code City,state,and ZIP Code
Haubstadt, IN 47639 Evansville, IN 47712
Country Country
U.S. U.S.
E-mail address
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
atuure of ellern f�� , Si �ureof Selig pri ed Name of Seller Date signed(mm/dd/yyyy) P nt d Name of Seller Date signed mm/dd/yyyy)
4/4 - f v1 e- rG14-/ obi //a y Debra S. Rietman, 54c Tru1Tf c (+// ,/
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on o document
Rachel Nicole Ziliak '
D-------
Address(number and street) Address(number and street)
109 N Eileen Ave
City,state,and ZIP Code City,state,and ZIP Code JUN
Haubstadt, IN 47639 Y ? d324
Country
certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
El 1.Will this property be the buyer's primary ❑ ❑ 3. Homestead
residence? ❑ 0 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated ❑ D 5.Wind Power Device
for this residence? If yes,provide address: ❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ El 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 96,�/. I`va f
�rQ 40 1-000.IIn.-- oa9
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